First Metatarsophalangeal Arthrodesis for Hallux Valgus

Wood, Edward V.; Walker, Christopher; Hennessy, Michael S.

doi:10.1016/j.fcl.2014.02.006

Cited by 17 publications

(8 citation statements)

References 45 publications

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“…Arthrodesis is rightfully considered the gold standard approach to end stage arthritis of the first MTPJ and to treat failed arthroplasty or hallux valgus surgery as a salvage procedure [ 2 , 3 , 6 ]. When performing a joint fusion is important to follow the Glissan principles of arthrodesis: careful joint debridement, alignment in optimal position, close fitting of the fusion surfaces and finally stability at the fusion site [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The first metatarsophalangeal joint (MTPJ) fusion is a surgical procedure firstly described by Clutton in the last decade of 19th century [ 1 ]; despite of the several modifications introduced in the following years, it is still considered an effective technique for the treatment of several disorders of the first ray. The indications for fusion include MTPJ primary arthritis, severe hallux valgus or hallux varus and after failure of primary corrective surgery of these conditions [ 2 , 3 ]. First MTPJ fusion aims to obtain a stable toe in order to reduce pain and discomfort.…”

Section: Introductionmentioning

confidence: 99%

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First metatarsophalangeal fusion with dorsal plate: clinical outcomes

et al. 2021

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Background First metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions. It can be achieved through different techniques. We evaluated the outcomes in a cohort of patients treated with dorsal plate arthrodesis. Materials and methods We treated 30 feet for 28 patients; the mean follow-up was 35 months. For each foot, we collected radiological and clinical assessment, with the visual analogue scale (VAS) for pain and the Manchester and Oxford Foot questionnaire (MOFQ). The technique consisted in a cup and cone arthrodesis with the application of a low profile dorsal plate. Patients were allowed for immediate weight bearing. Results Consolidation was achieved in all cases; in 29 cases, radiographic union was recorded within 6 months from surgery, in one case after 9 months. Comparison between the preoperative and postoperative of VAS and MOXFQ values showed a statistically significant difference (p < 0.05). Only one case developed wound dehiscence as complication. Conclusions Even if there is still a debate regarding the best system for MTPJ fusion, we believe cup and cone fusion with dorsal plating is an effective method. Moreover, the stability of the osteosynthesis obtained allows for immediate post-operative weight bearing, making patients able to return soon to their normal life. Trial registration We present a retrospective study; all patients enrolled were retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

First metatarsophalangeal fusion with dorsal plate: clinical outcomes

et al. 2021

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“…Arthrodesis procedures involving the first ray (first metatarsalphalangeal joint and first metatarsal-medial cuneiform joint) have traditionally involved a period of postoperative non-weightbearing cast immobilization until some radiographic evidence of osseous consolidation has been observed at the fusion site (318)(319)(320)(321)(322). In addition to limiting the indication of these procedures to patients able to withstand this protocol, prolonged immobilization inherently has concerns for muscular atrophy and the development of venous thromboembolism.…”

Section: Postoperative Considerationsmentioning

confidence: 99%

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

Meyr

Mirmiran

Naldo

et al. 2017

The Journal of Foot and Ankle Surgery

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A wide range of factors contribute to the complexity of the management plan for an individual patient, and it is the surgeon's responsibility to consider the clinical variables and to guide the patient through the perioperative period. In an effort to address a number of important variables, the American College of Foot and Ankle Surgeons convened a panel of experts to derive a clinical consensus statement to address selected issues associated with the perioperative management of foot and ankle surgical patients.

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“…F irst metatarsophalangeal (MTP1) joint arthrodesis is usually indicated in the end-stage osteoarthritis of the MTP1 joint that is refractory to conservative management, severe hallux valgus deformity more than 40° of hallux valgus angle (HVA), and salvage procedure after unsuccessful primary forefoot surgery [1,2]. This procedure is an effective solution that controls pain and provides deformity correction with a…”

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confidence: 99%

Footwear alterations after first metatarsophalangeal joint arthrodesis

May

Ünal

Katı

et al. 2022

The European Research Journal

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Objectives: This study aimed to examine the footwear alterations following first metatarsophalangeal (MTP1) joint arthrodesis. Methods: A retrospective review was performed on 37 (42 feet) patients who underwent MTP1 joint arthrodesis between January 2014 and January 2019 in our institution. Functional outcomes were assessed with the American Orthopedic Foot and Ankle Society Hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale, and the pain was assessed using the visual analog scale (VAS). Besides, time to return regular footwear, shoe preferences, the cosmetic appearance of the feet were evaluated and compared with preoperative status. Results: The mean follow-up time was 12.0 ± 16.5 months. The preoperative AOFAS-MTP-IP scale improved from 46.6 ± 7.0 points to 86.2 ± 7.2 points (p = 0.001), and VAS decreased from 6.3 ± 1.8 points to 1.4 ± 0.5 points (p = 0.001). There was non-union in three (7.1%) feet, and the mean union time for the rest of the feet was 8.2 ± 1.1 weeks. No other complications were seen. The mean time for resuming regular footwear was 11.8 ± 2.6 weeks. Patients' perception of the appearance of their feet improved from 3.9 ± 2.8 to 9.0 ± 0.7 points (p = 0.001). Twenty-nine (78.6%) patients (33 feet) reported that there was no restriction in footwear compared to the past, but 8 (21.4%) patients had to choose specific types and models. None of the patients had to use modified or custom-made shoes. There was significant change in the heel height preferences after the surgery (p = 0.004). 18 (52.4%) patients had to choose shorter heel height than preoperative preferences, whereas 19 (47.6%) patients' preference did not change. Almost all patients, 36 (97.6%) were using athletic shoes in their routine daily life. Conclusions: MTP1 joint arthrodesis is a reliable method that controls pain and increases function with a low rate of complications. However, significant alterations in footwear preferences may occur. Patients should be informed adequately about these outcomes to modify patient expectations.

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First Metatarsophalangeal Arthrodesis for Hallux Valgus

Cited by 17 publications

References 45 publications

First metatarsophalangeal fusion with dorsal plate: clinical outcomes

First metatarsophalangeal fusion with dorsal plate: clinical outcomes

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

Footwear alterations after first metatarsophalangeal joint arthrodesis

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